Office Insurance Quote Request for Your Business Needs

Contact name

Phone number

Correspondence address (If it is different from the address being insured)

Insurance renewal date:

Current insurer:

Premium:

Business Name:

Trading name:

Status of entity:

Company registration number:

If applicable

How many Directors and/or Partners the business has in total?

1) Full name / Date of Birth / Position within the company:

2) Full name / Date of Birth / Position within the company:

3) Full name / Date of Birth / Position within the company:

4) Full name / Date of Birth / Position within the company:

Business Trade description:

Date business established:

Select any of the following that apply to any Director or Partner of the Trade or Business or its Subsidiary Companies if they have ever:

had any convictions or criminal offences which are not spent under the Rehabilitation of Offenders Act or have any prosecutions pending
been declared bankrupt or insolvent or been the subject of bankruptcy proceeding or insolvency proceeding
been served with prohibition or improvement order under health and safety regulation
been the subject of a recovery action by Customs and Excise or the Inland Revenue
been disqualified from holding company directorship
had CCJ's and/or Sheriff Court Decrees
Not applicable

Select any of the following that apply to any Director or Partner of the Trade or Business or its Subsidiary Companies if they have ever:

had insurance cancelled
had a renewal refused
had a proposal refused or declined
had special insurance terms imposed
Not applicable

Does the business have any employees?

Total number of employees:

Employer PAYE No:

Estimated Wageroll (next twelve months)

Are any employees paid below PAYE threshold?

(inc. LOSC, trainees, apprentices)

Does the business carry out any treatments?

Please list all the treatments that the business carry out:

Please state N/A if not applicable

Please specify the number of qualified staff for each treatment:

Please state N/A if not applicable

Estimated Business Turnover (next twelve months)

Percentage of turnover derived from second hand goods?

If applicable

Business address to be insured: (Property Name, Building Number, Street Name, Town, Post Code)

Does the business also own the building?

Date of purchase:

Property Ownership Name:

Land Registry Title

Business hours:

Are there any other occupants that use the premises?

If yes, please specify tenant/trade types

Is the business not self-contained with its own means of access?

Is the property in area with history of flooding?

Is the property of non-standard construction?

[walls not built only of brick, stone, concrete or roofed only with slates, tiles or concrete]

Is there an ATM on the premises?

Is the premises in a good state of repair and free from damage?

Is the property a listed building?

Please specify listing grade:

Number of storeys where floor is of concrete construction

Number of storeys where floor is of wooden construction

What materials are the property walls made of?

Please provide percentage split, if the walls are made of more than one material

What materials is the property roof made of?

Please provide percentage split, if the roof is made of more than one material

Is there an area of roofing flat?

Please state the approximate percentage of the roof being flat?

Heating and fuel type:

Please select all risk management features that you use for this property:

Wired Fire Alarm
Intruder Alarm
Sprinklers
Other
None

Is the intruder alarm maintained by accredited company?

What type of signalling your alarm has?

Redcare
Digicom
Bells only
Other

Accreditation of intruder alarm:

Is the alarm connected to the Police response?

Please specify other risk management features:

Are your sprinklers maintained by Loss Prevention Certification Board approved company?

Sprinklers accreditation details:

Please specify type of door locks

Please specify type of window locks

What type of other Security Aids does the business use?

Private CCTV
Other monitored CCTV
Town Centre / Local Authority CCTV
Access Control
Shutters
Window bars
Guard dogs
Security Patrols
No additional aids
Proposer/family members or employees living above

Do you have 30 days of more recording facilities on the private CCTV?

Reinstatement sum of the building? (Including fixed glass, landlords' fixtures/fitting)

Date of purchase

Reinstatement sum of the Shop or Salon Front

Reinstatement sum of Computer & Electrical Equipment

Reinstatement sum of the Tenant Improvement

If applicable

Reinstatement sum of the Business Stock

If applicable, please exclude: Wines, Spirits, Tobacco and Cigarettes

Reinstatement sum of the Business Frozen Stock

Please provide a number of fridges & freezers and maximum reinstatement sum of frozen stock in each of them.

Does the business sell any Tobacco, Cigarettes, Wines or Spirits?

Reinstatement sum of Wines and Spirits

Reinstatement sum of Tobacco and Cigarettes

Does the business keep any money in Safe or Strongroom on the premises?

Please provide the Safe Make - Model - How is it secured?

Required length of indemnity period for Business Interruption Cover?

12 months
24 months
36 months
Not required

(The period that begins after an insured event occurs and ends when the business is back to normal or when the policy's maximum period expires.)

Estimated Gross Profit for the next 12 months

If applicable

Required Limit of indemnity for Public Liability

Required Limit of indemnity for Product Liability

Required Limit of indemnity for Employers' Liability

Have you had any insurance claims within the last 5 years?

Please provide: The date of the claim, Cause of the Claim, The Claim Amount & the Outcome:

Any addition information?

GDPR Agreement *

I consent to having this form submitted so Prestige Insurance Brokers (UK) Ltd can respond to my inquiry by phone, email or a message.

Fact-finding questionnaire to request an insurance quote

for Offices anD professionals

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